Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Tuesday, July 31, 2007

No, I am not manic

I always get a little irritated when people ask me this because I have done something like buy a car or a house. I put every bit as much time into those purchases as anyone else. I know why they ask, but it is another reminder nothing is normal.

This time though I expect to hear it and I'm not. Guess what I'm doing right now? I really would love to make you all guess, but I can't.

I'm writing a resume! Why? Well, I like the company I'm working for a lot. I know my time in longterm care is limited, and I want to enjoy it the best I can though, and there are issues where I am working that I don't like much. An opportunity has come along that seems too good to be true (and it well might be), and when the second opportunity for the same job came along (and when I saw the pictures of this place) I felt I had to check it out. So I have an interview in 2 days.

Interviews for OTs in this area aren't really stressful. In fact I don't think I've ever had a real interview since my interviews as a new grad, and those weren't really traditional interviews, just a different experience than my other jobs which have practically hired me without even discussing it. So I'm not worried, but I made a really bad decision with my resume program and it's giving me fits. Ugh.

I'm only taking this if they agree to a lot of very specific things they probably won't. It's probably a long shot.

We shall see.

Saturday, July 28, 2007

What comes now

I have had a week off of therapy and time to think hard about some of the issues that came up over the last month. I have had quite a tantrum, some completely fair, some not, directed at my therapist. So much of my anger has been related to not understanding how he saw me when it wasn't how I saw myself, how I knew others saw me. That changed when I realized that it wasn't him being mean, it was me thinking of myself with the traits I had before, traits I assumed I'd regain and which I didn't. Some of it I guess I knew; I know I think differently now, that my memory is different and that I think more slowly sometimes. I know that I react to stress differently than 18 months ago. I even know specific things that have changed. I'll never admit this to anyone because it makes me mad, but I read so much more slowly now and even then I don't always remember what I read. In grad school we had a class where each week we'd be assigned a theory and have to read every article about it and discuss it. Everyone else had all these note cards about each article; I would have a list of articles I read and maybe a couple words beside it if the author had published a lot about it and I needed to differentiate articles. My memory just worked that way. Now it's hard to get through a book without backtracking. It is hard to adjust to "un-knowing" yourself, and I've been fighting it by pretending nothing changed.

Refusal to even admit that something is a characteristic of yourself isn't really helpful in the intense kind of therapy I've been doing this last year. I have been basically refusing to admit that I was anything like I am right now. I have managed to be more honest with myself about parts of this, like the frequency of my manias and that I do not recognize mania a lot of the time. But I have a long way to go to figure out who I am again.

I have to figure out how to be this person I have become and yet be nice. I think I could like myself again if I could figure out nice. It's so hard though to figure out what I lost and don't see and the therapist is useless there because he didn't know me before.

This will be interesting.

That was different

This week just was different. I guess I was hypomanic the week before because I had less energy. I am still sleeping very well with this cutting 1 depakote ER in half to make it immediate release thing. However I'm back to needing many hours of sleep, so something still may need adjusted a little. I don't really care; it was great to have a week of being awake but I still feel good and that's the really important thing. I've made it through my therapist's vacation and truthfully barely noticed. Maybe I will start thinking more about less appointments. (Don't tell him though!)

I am getting more frustrated with the nursing home where I work by the day. It's got nothing to do with therapy, except that the care there stinks and in ways it's hard to ignore. I learned long ago and the hard way that I can't worry about many of the things that happen, even when I know they aren't right. This is becoming a situation where I'm wondering if a good therapist would stay, period. I kept thinking things were just having a downshift; now I'm thinking the reverse. I think that's part of why I've been quiet; I've been thinking about this a lot.

I had a long meeting with vocational rehab yesterday. It was the first time someone has told me that I may want to consider SSDI. I am so not ready to do that yet, or to hear that. I need to try a few more avenues before I close doors. It kind of scares me to hear this from voc. rehab. He's not saying it based on my OT eval, which isn't finished, but on his interpretation of what I'm saying, which I'm not sure he is hearing correctly.

There's nothing wrong with the SSDI route, and I know I'll probably end up there. However, it's not right for me at this point. I need work. I need the forced time outside of my cocoon. I need the sense that something still is somewhat normal. I need things that come with working, like insurance that allows me to see my really good doctor. I need the money to pay out of pocket for my therapist, a person who meets my specifications. I need the independence I have now. Not working would mean losing all of that. My doctor fully supports this and wants me to work until I can't.

I do need some changes. I probably need to just find a way to exist on a 32 hour full-time job. I'd do that right now if I could be certain I'd get 32 hours, but I couldn't. Plus the longer I work the more debt is paid off. I never would have gone to grad school if I'd known this illness was coming....

I say all this calmly, yet part of my brain wants to scream "I'm not that sick! No, no, no!"

Wednesday, July 25, 2007


This one is ironic. I am feeling good and sleeping the best I have done in forever (like falling asleep before midnight and sleeping all night!) and it's taking all my free time. I'm not blogging much because feeling better is, right now, meaning even more sleeping time than before, even though I'm not tired all the time. I've had a busy week so this may adjust itself some, but for the moment I'm tired.

I got a call about a job that I'm really interested in. I don't think taking it is probably in my best interests, but it's something to think about. It sounds really good. There are things at my current job I don't like. Nothing to do with my company or me or anyone I work with, just things I'm not comfortable with. But changing now is not in the master plan.

So anyway, not a whole lot really to say. I started yesterday distractedly trying to figure out how to cram my patients into my day and sprayed my hair with lenscleaner instead of hairspray. That was interesting.....

That's about it. For now I'm just being so very thankful for boring.

Sunday, July 22, 2007


In case anyone out there is as dumb (thoughtless) as I am: Corn husks do not do well in the disposal. Unless you want perfectly shredded strands of corn husk, in which case, go for it.

Multitude of stuff

This post is going to be pretty disjointed......I have had a busy week with a good bit on my mind, and combined with my med changes I've pretty much just been working or sleeping. I feel really good and am actually falling asleep very soon after I take my meds, which is a big change for me. I think I'm currently maintaining some hypomania which is letting me function well, but I'm honestly not totally certain. So that's where I've been, basically trying to figure things out. Now, on to the randomness...

  • I have been bipolar for a long time and very rarely have been not in some kind of episode. I have gotten good at recognizing where I am, mostly, and over time have earned the right to adjust many meds myself based on knowing how I react and feel at any given time. If I say that I need to increase my __ by however many mgs, chances are good that will happen, even if I'm suggesting an odd number. But hypomania? This is new. Pleasant, but new. Because I go into mixed episodes so easily and because my manias are the irritable, angry, unpleasant kind I have little experience with bipolar doing anything that feels good. I like this. I believe my doctor has said that if I can find a hypomania that I function well at and don't have bad manic symptoms that she will let me coast there. I really hope this is it, because I like it.
  • Crazy public service announcement but I can't stop thinking about it and even dreaming about it. Apparently kids (at least in this area) are really getting into dirt bikes and parents are giving them to fairly young kids, with lots of padding equipment and the belief that helmets and padding prevent tragedies. Well, the last few years taught me a lot about dirt bikes, motor cycles, 4 wheelers, etc. For some time I worked with brain injured patients and there were always several at any given time who had acquired their injury with one of these devices. I thought I understood them how much can be taken away by taking a risk that seems small, but I didn't. My uncle had a motorcycle accident a few years ago. His helmet saved his life but it did not stop his neck from being snapped back. His brain injury was minimal but the spinal cord injury was pretty devastating. My image of him through my whole life was an active person, very independent, and now, well, he is doing well, but he's in an electric wheelchair and always will be. You cannot pad or externally stabilize your neck. Human versus tree/sign/wall/rock/car/etc. is going to result in human losing. The most minor injury I've ever seen from one of these things resulted in permanent loss of movement.
  • I'm facing a week with the tiniest support system ever. My mom is on a cruise ship and my therapist is on vacation. I'm glad I'm doing well enough that I will be fine, but I'm nervous as well. It is hard to be confident I am handling anything that comes up appropriately without feedback. I feel really good that I've improved enough from last year that I am doing this without all sorts of "in cases" set up. Last year I had this week all set up so that I was checking in with the psychiatrist instead, and another therapist was prepared if I needed to go up there. I honestly don't know if that's even set up this year; I know I said I'd be ok when it was mentioned, but I also know I could get in to see someone if I needed to. I just don't know how it would help since a stranger isn't going to be able to do much.
  • I am very, very thankful to the people at Morning Sunrise. They make the True Sun clock which has made my life much easier over the last year. This clock has a feature that creates a sundown at bedtime and ultimately turns out the light, then slowly wakes you up with gradual light in the morning. It's expensive, but for me, very worth it. The thing is that mine broke last month and was still pretty new. I contacted them and without even asking questions or requiring me to do a thing I had a brand new unit on my porch yesterday, sent FedEx, nonetheless. It took less than 2 weeks from when I contacted them. Such great customer service. I think it's probably a bad sign about our usual customer service in this country that I had decided I hadn't heard from them and they weren't requesting the old unit or shipping fees so I would never hear, and was going to order a new clock.

I think that's about it for now. I have to do a lot of laundry. I'm trying to figure out the best way to wash my weighted blanket. It is supposed to be hand washed, but it really needs more because it is a cat hair magnet. I think I'm going to risk the delicate cycle. Really hope it's not a terrible idea because I don't want to have to wait a week to sleep....:) I found better ones online for my next one that are a better fabric. My favorite site so far and the one I will probably try for my next blanket because they make large, adult sized blankets, is this. I like the idea of having something less clinical looking and maybe even something that matches my room. Plus the idea of not attracting cat hair is fabulous.

Wednesday, July 18, 2007


Today was my OT eval. The one in which I am the patient, not the professional. It's not done yet, but the worst is, I think. It was hard, mainly because it is hard to have a stranger with expertise in your field watching you and not feel you might be judged (even though she is not there to say anything about my clinical skills she is obviously watching them).

She made some good recommendations just initially, mainly things the manager can do to facilitate communication, education, etc. It was so good to have someone substantiate what was a hotly contended statement I made in the spring, that on very hot days it was dangerous for me to be outside and my time out needs to be minimal. Can I walk to my car? Yes. But every trip, every minute during the day I'm out adds up, and I become sick, shaky, dizzy, and exhausted. Just a little too much heat and I'll have definite lithium toxicity signs. Not true for everyone, not even the way it used to be for me, but after the toxicity my body just seems to have a built in safety system that triggers flushing of lithium as soon as the levels go up a bit.

It was hard listening to the manager explain how my assistant gets angry and feels like I'm expecting "special treatment". I'd love to know how. All of us have flex time. It's the nature of the work. I do expect my effeciency requirements to be reduced. I have cognitive impairments so that seems fair. Beyond that, I do my entire caseload, every single day. I do a large proportion of our administrative stuff, like screens, ordering equipment, etc. I am not very organized. I make paperwork errors more often than I should, but very rarely in a way that really impacts her. She hates sharing desk space with me because she doesn't want any of my stuff out, and it bothers her when my inbox contains things other than paper. But it is my inbox which she doesn't get into so I don't really care. She tries to put away my things, especially my stressball frog with funny eyes, but I have learned to just get them right back out. I probably would feel sorry for her and try harder (and I did when our desk was smaller), but she keeps pictures of her boyfriend and family out in a way that means I sure couldn't put pictures up if I wanted, and frankly her boyfriend scares me a bit. Not him, but the camera angle. I think it's supposed to make him look interesting and exotic or something, but to me it just looks slightly scary because he seems disportionately large, which I'm sure he isn't really. So I figure we can trade creepy frog for bad photography.

This does however leave me questioning how much I do leave her to compensate or expect her to? Or if I leave that impression somehow. I think some of this goes back to this patient who used to get kind of agitated with afternoon treatments. Another assistant noticed this and suggested he be treated in the morning. I was not there in the morning because I was in another building, so I did ask she treat this gentleman. It had nothing to do with me at all, other than I wasn't fulltime in the building.

I was finally able to point out that nobody ever asks me about my illness. I'm not sure the people I'm working with completely understand that I know my illness and myself very well and that if you ask me why I am doing something I may be able to answer, and if it's unintentional and needs stopped I usually can. I can control 99% of my behaviors a majority of the time, it's just I am not aware of all of them.

I just wish I could pour the contents of my head out and let them try to really understand. The OTR said the same thing everyone else who ever has evaluated me has said, that I have some amazing skills in unexpected areas. Obviously I also have amazing deficits in others. I understand perfectly why it seems so discordant to people that I have trouble remembering to do routine paperwork sometimes, but am totally able to remember all the treatment codes for each person at the end of the day if I don't write as I go which I generally do. I can remember incredible amounts of what I read. I used to have a nearly photographic memory, so this is a decline, but I still can accurately give most patient's doctor, medical history, etc. as long as I've treated them once. Yet I have trouble remember a lot of verbal stuff.

I need to turn off now; more later I am sure.

Tuesday, July 17, 2007

Is courage a choice?

So I spent the entire last week thinking through all these complicated variations of arguments with my psychologist. I looked at every issue I could think of, every way I could think of. Thankfully my mood stayed good, and I had the monumental moment of the first friends to ever visit me in this home, which I have owned 4 years. This is a big deal which I'm getting a lot of attention over because I just did it and I'm not usually a just do it kind of gal.

So instead of immediately confronting him with "this week has been TORTURE" instead we had a lot of celebrating, and it was well-deserved celebrating. Now that I'm taking that one pill as an immediate release and taking round the clock anxiety coverage my most recent med changes are really doing some good and I'm getting the luxury of a bit of a break. The cycling I am having is into hypomania and I never, ever go there. I like hypomania...

But then I did venture into the "why did you say I'm not doing well at this" territory, and practically the only reaction I hadn't considered was what I got: pure shock. I don't know how I misunderstood the way I did, my best guess is that because I was manic and having a terrible time focusing I tuned out after the first part of his sentence. Oops......

So then he reminded me that he had told me how strong and courageous I am. I told him (again) that I don't see this because it's hardly a choice; to live, this is what I have to do and I certainly do not take it on for any other reason. He says that since it is an option to give up that not giving up means I'm courageous. I have a tainted view of that word because it seems to come an awful lot from people treating me and well, they are getting paid to be nice. When they all settle on one thing I figure that means it's an easy option. Or the only option.

Anyway, what do you think? Is courage a choice? Said otherwise, it is courageous to live the life you've been given when that life is equipped with some extra challenges?

Monday, July 16, 2007


1) Things are ok with my psychologist. Huge misunderstanding on my part. More on that later, too tired now.

2) I think it says something rather bad when my med list is one of the top five google hits for "master list of antidepressants". Of course I have been on nearly all, so I guess it's fair...

3) I think my doctor has given me a new huge gift of energy. She told me to try cutting one of my depakote tablets in half to break the extended release seal, then take both halves. This makes it immediate release. Suddenly I'm sleepier earlier and awake so, so, so much sooner. I'm loving life.....

Saturday, July 14, 2007

Here I am

I'm back. Still have tough stuff on my plate, but I have at least gathered the information I need so that I feel like my thinking is ok and I can go forward with handling it.

My problem is that I reached a weird point with my therapist. I discussed that a bit a few weeks ago. Last week we talked about it a lot more, and he brought up things indicating that he thinks I may not be progressing much, that he questions the benefit, etc. I talked to him about how it seems he always thinks I'm being negative when that's not how I'm necessarily really thinking, or how I am even when that's how I'm acting.

Then we had a discussion that was difficult for me because I was telling him I thought he wasn't understanding some of what I was going through. That went immediately into well of course he couldn't but he did respect my situation, etc. However, that's not what I meant.

I've lived with bipolar quite some time and so I am well past grieving its presence in my life. I have known from day one that my situation was complex and that I would not have good stability; adequate was the goal. In time I learned that adequate stability meant a lot of stretching on my part, but it was liveable and I was finding good things in life again. Until I got so very, very sick in January 2006. I consider that the bad period really began more like late October of 2005, but it was more typical of my cycling then; bad and annoying but causing the constant threat of disability.

Over the last 11 months since I returned to work I have had to face so many new realities. It was almost like being diagnosed again as I struggled to learn to live with the new limitations. Oh, let's be honest, to even admit I had limitations was a struggle that was about 6 months of therapy. And now I'm having to admit that I will need to leave this job path that I love so much soon.

I never did exactly well, even for a bipolar patient and I was always considered quite unstable. My first few years were the ones with most of my horrible med reactions, so that did not help. But those first years I did have two or three month sequences where I would be ok or better. I went for periods of time without med adjustments. I was ok between monthly visits with the psychiatrist most of the time.

Everything changed when the bad episode started. Since then I have had only 2 (today being one of them) psychiatrist visits when meds weren't changed. Even though we usually follow a one at a time process thanks to my reactions there have been a number of times I've needed multiple changes at once. Besides that there has been frequent email contact with my psychiatrist. I've had 2 problems severe enough to require my family doctor call the psychiatrist. I'm very, very unstable all the time. I no longer get to ignore my disability, ever. And the impact on my life went from being pretty bad to being horrible.

On top of that I realized I've burned through so many medication options. I've retried anything that I thought I had been wimpy about taking, but most of the reactions I've stopped for were dangerous. I have known for quite a while that I was probably going to face a point when the meds weren't there like I would need. I never thought it would be so soon.

One of my personality traits is a desire to be prepared for things. I do much better with emotionally difficult situations if everything is explained in advance. I need to cope with the fear and anger and whatever before I'm also coping with emotions. This makes sense when you consider my already out of control emotions; it reduces the response later.

So in the last months I have been through a process of grieving and being angry about my illness progressing. I've had to accept that my days of pretending for one minute that this isn't going on seem to be pretty well over. Further I've had to accept that the losses are going to continue. And I've had to accept that it is very likely I'm going to face some ugly treatment decisions soon, decisions I never wanted to make. Decisions that make starting lithium look easy, and I thought that was pretty monumental.

My therapist came into my life when I was already very ill last year. He's never seen me at the level of functioning I still want to think of as "typical" for me, even though I'm beginning to know I need to live in the now and define typical as the way I'm living. I don't think he understands how hard the adjustment in thinking has been, partly because he has no way of seeing how much I have changed. I don't particularly like myself now either, but I just woke up from a long time of being too ill to care. I'm working on it, but I don't know who I am in the strange new land. I don't know if anyone but me could see a difference, but I think it is there from my early posts to the ones 4 months later and beyond. My therapist sees only the person he has known during this time I have not been well and to him that is the real me, when to me the real me is now unknown. I'm trying hard to quit thinking of myself as the way I was, but it's hard to not remember.

I think I left my therapist out of my coping with these things. I talked about it, but I don't think I did well problem solving through it, nor letting him help. I am sure I didn't say a lot to him about relevant parts. Maybe it feels too private, and surely there are certain things I get to find to be too private, or maybe I was embarrassed, or maybe it was something else, but I think he's listened to months of my talking about the parts I was upset about but not moving on, while in reality I was doing so, in my own way. I'm there now. The day I became certain it was time to move on in my career and had good reasons and a plan for how to do it, a plan that probably involves the dreaded hospital, I'm good. I just don't think that is very clear to my therapist.

I'm really worried. There is a lot more to discuss because this just didn't get concluded last week, but I think he's giving up on me. I understand in ways, but in other ways I'm hurt and angry and confused and many other things. I have done a lot wrong, but I think there are ways he just simply isn't getting what I'm talking about because even when I try to explain Just Me 2005 edition and Just Me 2007 edition and why 07 is still trying to turn back into 05 with some improvements he can't seem to picture 05. He's not been there for the worst med reactions, nor has he ever seen what has happened to me on all antipsychotics. There are 3 more to go. The thing is that we can be pretty sure at least one will do something really bad. So far no antipsychotics have worked. Well, they work but they do bad things to my body. I felt good on one of them, good enough I think it might have made a major difference in my life, but it had dangerous side effects (scary blood pressure). I have good reason to be wary of these meds.

Today I talked to my psychiatrist a bit about whether my feelings about having changed abilities, etc is valid based on the 2 years ago comparison. I also explained my theory. She was supportive and I believe is going to try to talk to him to touch base. That in turn makes me feel squeamish because it's hard for me to think of people talking about me, especially when I know perfectly well one isn't so thrilled with me.

I'm dreading weeks of trying to work this out. I feel like I'm failing therapy, something I didn't really use to think was possible. I guess it's good I'm well enough to take this on because I've been aware for a long time something was wrong I didn't want to face, but still, this involves doing many things I hate, all at once.

Friday, July 13, 2007

To fill space

Still not really writing, but as an interlude while I'm gone (probably will post tomorrow):

Point to ponder: Why do my Q-tips have an expiration date??

Weird, weird world.

Tuesday, July 10, 2007

In a cocoon for a few days

I am mainly writing to say I'm not sure I'll be posting a lot in the next few days. I need to think. A lot. And the situation I'm thinking about is confusing and scary and I need to just think and get input from a few specific people before I say much more. In short we weren't done with our difficult discussion last week I guess, and I'm not sure why he decided that a day I was manic was a good choice of a time to throw in more of something hard for me to handle. This was after we decided a few weeks ago I don't do well with new stuff when I'm manic. And it came up too close to the end for me to fully react, which means this week is feeling like torture, already. I want to go back and demand the conversation be finished but I also really want to hear my psychiatrist's opinion this weekend. So, 5 more days.....

But in the meantime I have a lot of thinking to do and thus far a lot of crying. I am fine, I really am, I just am thinking and it is so hot that I've been going to bed very early because I'm drained by the end of the day. All thoughts are going to be centered around one thing anyway, and it would be boring for anyone thinking of looking inside my head.

Instead, read this. Sarah sent me this meme a while back and I didn't realize that it posted a week earlier than it was completed. Oops.....

Back soon. Maybe sooner than I think. Who knows.:)

Saturday, July 07, 2007

A new thing I hate

It's not new really. It's just worse. And today is a bad day and I'm generally frustrated and needing something interesting, and instead I'm feeling one more limitation on my life. What now, you ask?

Well, I take a total of 7 prescription meds. Of those 4 have warnings about heat and/or sun exposure. They aren't kidding. Lithium levels are affected by heat. That at least I can combat somewhat by drinking lots of water. A liter of water used to buy me an hour or two. Depakote and heat don't mix at all for me. It wasn't bad on moderate doses, but when I hit the high dose I started being able to tolerate only a few minutes in the sun before turning bright red, feeling dizzy and becoming nauseous. It's gotten even worse this year, to the point that just being at work where the air conditioning is limited can make me feel quite ill and I've had a few dizzy spells. Once I thought I was going to faint. So essentially I am stuck inside at all times unless it is below 80, and 70-75 is more preferable.

It's been a hot summer. Circumstances have also made it a sort of boring summer for me. Between being sick with bronchitis and then having Lamictal rash I lost 4 weeks. I have barely done anything for fun and have only been to my mother's about once (she lives very close and I usually am there nearly weekly). Today it really hit that I want to do something and there is nothing I can do. There's a festival here and I just wanted to walk through. It seems like the whole town was up there earlier. But it's over 90 and humid, so here I am.

I grew up outside. I was a camp counselor, the nature counselor. I was 22 before I spent a summer at all inside, and that was because I was in school. Even that summer I was outside plenty. I love canoeing, hiking, gardening, just being outside. And I've given it up for this illness. Last summer in therapy we made a list of things I'd given up and worked on making peace with them. Well, we forgot one. Last summer it was a bit cooler and wetter, so this wasn't as bad. Two years ago I was stuck inside constantly. That year I actually was forced to spend most of my savings on central air because I was having mood swings from my house being too hot for me to sleep in.

I'm angry. This is something that isn't likely to change; it comes from meds I'm likely to remain on indefinitely, and most other options have the same side effect anyway. So I've spent most of today just like my cats: looking out at everyone else going by. And crying. Actually I'd feel better if I could just cry for a while, but right now I'm still adjusting to my new depakote levels and high levels always result in it being very hard for me to cry and let emotion out. This has actually led to my quitting meds for several days before just to get relief. (Not recommended). It will get somewhat better but not totally. However I generally cry easily in therapy so I just have to make it there, I guess.

I'll recover. I need to arrange something to look forward to soon. I don't take vacations in the summer because I'm so limited in what I can do. Just as the sun sets I usually can be outside for a bit. I hope to plant a couple bushes tonight. We'll see though because it's still pretty hot out there. Plus there are those stupid fireworks. Because we live in a valley each boom echoes many times. I get to jump many, many times.....

I see retreating to my hammock in the icky basement in my future.....


A recent comment from Diana mentioned she wished she could be as open as I am about my illness.

That's something I've been thinking about a lot lately. In an ideal world, mental illness would not cause us to need to consider being secretive at all. This is far from an ideal world. Oddly though, I am more open in real life than I am on the internet, where I do not use identifying information. In real life I talk about being ill a lot and I try to educate as I go, which has currently become one of my greatest frustrations because the people I work with don't really listen or accept that I am the expert on this disease/my version of it.

On so many levels I resent that this blog is cloaked in so much anonymity. I have been more free than I thought I would, and if you were incredibly bored and had a lot of free time I know at least one way to figure out my name and probably where I live, but it's not a way you're likely to think of. It irritates me that I have to constantly remember to not use my real name.

Yet it lets me say more than I could otherwise. I can't talk openly to anyone about my plans to eventually leave my job, probably after a disability usage. They won't be thrilled about that, so I'll keep it quiet. I can't talk about how much my job hurts and frustrates me, because that's a good way to make it all worse.

Deciding to be open with the internet was really challenging. When this blog was started it was because I wanted a way to reach out a little. I was so tired of people assuming I was automatically not able to be who I am because of my illness. I was frustrated because I had earned a bachelor's degree in psychology and a master's requiring a lot of psychology knowledge and had not known that someone could be severely mentally ill and still be able to function. It was hard for me to accept that I could do this and that delayed my treatment substantially, especially since I had a psychiatrist at that time who was assuming I couldn't be that ill because I had educational achievements, a job any new therapist would be proud of, etc. So ultimately I realized I wanted to share that bipolar wasn't what people thought, hoping that it would help even one person not be diagnosed because of what they were doing, rather than what they weren't. I also wanted to help people understand that it takes a lot of variations to get the "average bipolar", yet everyone looks for this type. Again, I missed out on years of treatment that could have helped me not have nearly as severe symptoms because I don't meet stereotypes. When I was first diagnosed, the world guru for bipolar disorder I was seeing said this was especially true because I had severe and consistent symptoms but expressed differently. I have now developed some issues that are more typical, but then it was really hard to see a lot of what was happening. After a lot of trying to find a way to do this, a friend offered to share a blog with students in his psychology classes. Funny enough, I don't really acquire readers from that; I acquire a few glancers and that's it. But even then, the goal was to talk about my type of bipolar, not my experience. However, 8 days after I started writing my life started to drastically change and last year's episode started. Now I'm on the other side of that, but learning to deal with a life that was changed irrevocably. My baseline is worse and I know it. My abilities are worse and I know it. My good times are even more rare than before (and even more appreciated; even the current ok time is a very, very happy thing).

I truly believe that out of all bad things good comes. The good that came out of getting so much sicker has been that I have had to become so much more honest. It's too bad the blog doesn't go back a bit further so you could see this for yourselves, but before I was so sick and did not recover fully, I wasn't as open. I hid it nearly totally. I still have the ability to hide symptoms from pretty much everyone but my doctors unless they go above a certain point of severity. I try to do this less now because I got so good at it that last year I was severely manic for months before I had a clue, and that's not good. Now, I have no choice. I have become ill enough that if I don't tell my life won't work. I'm ill enough I have to have support from others, pretty much all the time. There's a great likeliehood that things will get worse for me before they get better, and that much of what I've lost in the last 15 months is gone for good. I no longer have certain basic abilities, so I have to ask for help.

It's hard and I'm still learning, but it is working. I'm still afloat. A year ago I was starting to feel better and still wanted to die most of the time. This year I'm living. That's a big accomplishment.

More to come

I am ok and I'll post more later. Not good to post about being off meds and then get very quiet. I have been struggling. Thursday I was quite manic. Friday it was better. However I had an incredibly busy week (of course) and was even more stressed because I had been committed to going to another facility to cover a vacation back when we weren't busy, but suddenly we did get busy and I needed time to get things done, but I couldn't do them because I was driving the huge distance to the other place.

There was a point Friday in the early evening when I literally felt fatigue hit like a 300 lb weight. I had no choice but to keep working and what could have been an easy treatment became hard, which meant everyone else I needed to see was in bed or not willing to do anything. So I got home just before 10 pm and at 10:15 I laid down to read for a few minutes before taking meds. I just woke up and it's about 5:45 AM......

So. Still here. Less manic. Exhausted, but tha'ts a good sign I controlled the mania...

Wednesday, July 04, 2007

Messed up med girl

I did get my meds today. The damage doesn't seem as bad as it could be, but I'm definetely going to have to hope I can settle things over the next few days. And these aren't the best days to need to calm down; my schedule is very busy and well, fireworks and I don't tolerate fireworks well. I am doing so much better than a year ago and have been very aware of that, but tonight I'm jumping a lot and my plans to go straight to bed were ruined.

I didn't sleep very well last night then made my life much harder by not waking to take provigil. I wound up with more work than I anticipated, so I went in late and didn't get out early. My assistant messed something up so that I treated someone she'd seen earlier, which has happened before, (actually last week), which didn't help that. So I flew through a lot of treatments that weren't good quality and started feeling that manic rushing feeling.

I am going to skip my antidepressant tonight for one dose to see if that will help by not elevating things more. Then tomorrow I'll shove my way through and hopefully tomorrow's dose will get me close to back where I'm supposed to be.

I do plan to ask the doctor for a stockpile. I think I had one a while back and it's been used up over time.

For now though, the fireworks seem to be slowing (boom) and so I'm going to try to make the first pills do the entire job.

No more mania.

Tuesday, July 03, 2007

Play time

Sarah tagged me for my first meme.

7 Things You (Probably) Don't Know About Me

1. I have a large birthmark on my arm and hand. One of my most embarrassing professional moments was when I was young and laughed without watching how people felt about what they said, and my patient's daughter told me an old wives tale that was really weird about how it was acquired. I laughed; she was serious. Another time I was working at an ice cream place and a customer grabbed my hand through the window and chanted over it. Not prayer, and she didn't explain what she was doing, she just chanted.

2. I was a long distance runner when I was a teenager. I was really determined and was expected to become a top athlete. I tripped and tore up my knee during my sophomore year. I was in incredible shape a year later after surgery when something else tore. I had more extensive surgery and worked hard to run part of my senior year, hitting 3rd from last once (my best). After that it was just too painful. Someday I'll need a knee replacement but for now it's actually in great shape considering I've not had cartilage for 15 years and I do a lot of kneeling.
(Jinxed myself; wrote this Tuesday and had it in draft. Friday I hyperextended my knee and it's sore).

3. The best award I ever won was an award that each high school in my state gives to one girl and one boy for outstanding sportsmanship. Traditionally at my school it went to the best male and female athlete. I was never that even if my knee had not fallen apart, but I was given it in recognition of how hard I tried to recover from the original injury, then both surgeries, and from my attempts to keep going when the surgery succeeded in letting me walk without limping, but not in letting me have my full athlete's body. I was given many things at my senior awards ceremony but that certificate made me cry.

4. I nearly failed my first semester of college. My high school was not academically competitive. It was in an area famed for poverty and there just wasn't money to compete with what schools in wealthier areas provided. I learned when I was so young I can't remember that equal distribution of funds to schools across a state has distinct benefits. I went to college as a biology major and during my first lab learned not only that I didn't know how to operate high tech microscopes (knew that going in) but that everyone else did. In contrast, my roommate had a planetarium at school. We did one lab a year and the 5 microscopes the school owned had mirrors. Both biology and chemistry 101 assumed base knowledge I didn't have. I had taken calculus in high school, but the level it had been taught at in my "easier" high school didn't compete with what kids in competitive schools had learned. My college has a high proportion of students in science and engineering, so the assumed knowledge base is far above what I knew. After I failed a round of tests I started freaking myself out and panicking so that I failed worse the next time. Tutors, tears and counseling helped. Ultimately I developed a ritual that I followed all the way through my board exam to be an OT, presumably my last academic test ever.

5. I am allergic to most facial tissues. They make me break out in a rash that gets more and more chapped every time I blow my nose. I am most allergic to the brand names and the ones containing lotions. I think the sensitivity has been greatly increased by lots of exposure from crying excessively thanks to bipolar.

6. I love fish. Unfortunately I don't know much about cooking it or what I like. I live in a very landlocked place. We never ate fish growing up because my parents didn't like it. Where I live is so rural that we don't have a lot of grocery access to "good" fish (like non-frozen). When I was in Florida this winter I ate fish at every opportunity and didn't find anything I didn't love. I just finished trying mahi mahi and I HATED it. But I never know if that means that my recipe wasn't good, if my preparation was lacking, if the fish I bought wasn't very good because it's been flown in from a million miles away and has been frozen for 3 years, or if I just plain don't like mahi mahi. This is disturbing as my latest craving has been fish and my daily dose mainly went down the disposal.

7. I think there is a difference in taste between caffeinated and uncaffeinated beverages. I actually prefer decaf tea and pop (which is good since that's what I have to drink), but I don't like decaf coffee much. I know caffeine is supposedly tasteless, but I can always tell a difference.

That was hard! Because most people reading here tend to feel pretty terrible rather unpredictably, I won't name names, but I'd love to have you answer either on your own blog or in the comments. I'd love to know you!

I did a very, very bad thing

I have severely messed up my mood stabilizers.....Severely only if you're me and precariously counting on something not likely to hold a lot of weight to do so. Moderately for others.

Every day I take 6 Depakote at once. If you have never seen a Depakote pill, they are very large, I think about 3/4" long. When I fill the script I get 3 bottles of pills. It's fairly obvious when you're running out of normal sized pills, but remember, 3 days worth of this medication for me is 18 pills. It's harder to see that the bottom is coming and anticipate. Then my insurance makes it even harder by being very rigid about no refills more than 2 days ahead.

Regardless, I ran out of Depakote Sunday night. Mondays are crazy here because I HAVE to be done with work at a certain time so I get to therapy on time, and it is a little unpredictable how many patient hours I'll have on a given Monday because it is affected by what happens on the weekend. My last job I could shift some time from Monday to Tuesday, but this job has less freedom about that.

I was running a few minutes behind for my Monday "MUST" schedule yesterday, so I didn't drop it off. It's hard to do scripts on Monday, but I can sometimes if I time it exactly right. Therapy was emotional and long yesterday, and I didn't get it together to think of filling it at a 24 hour pharmacy while I was in the city, since I no longer think in terms of 24 hour anything. So last night I missed it.

I knew that was bad, but one dose isn't the end of the world. Way back in another life, before my toxicity, I remember once being without for 4 days and still being fine going back on, but now I can't risk changing because I can't risk that it won't bring my level back up sufficiently. Plus Depakote is essential to knock me out enough to sleep and not sleeping will just add to the entire mess.

So today I got up early and dropped the script off. Because I was so early I never dreamed I would be too late for the pharmacy. But I was. I had a bad day. I think I was generally distracted in that way you sometimes get when something hard (yesterday's therapy) is over. There was mass chaos. I kept having to re-do things. I ripped both my pocket and the seam of my pants in separate incidents. I treated the wrong patient. Another patient needed TLC. Another one found out she has metastic cancer today. And I didn't do some basic things I should have. I did not make sure I was pouring in water. I was very bad about this today. My lunch was disgusting so i grabbed a candy bar with nuts in it but for some reason never ate it. I didn't even eat anything salty until I was feeling pretty bad. In fact devouring some french fries the speech therapist gave me clued me in on why I felt crappy.

So feeling bad because I messed up my lithium levels didn't help. Then I had to walk outside for a while which made it worse. I didn't think it was supposed to be too hot today and the actual temps weren't bad, but somehow it wasn't good for me. Maybe it was just slightly above my limit, or it was humid, or it was extra-hot outside. Whatever, it wasn't pleasant.

I think the lithium thing made me slightly confused, so it took forever to get paperwork and stuff done. I did leave to buy food (which was disgusting; I don't like to eat when I'm hot which just makes this all worse) finally but it didn't help much and so overall I was at work 11 1/2 hours. NOT GOOD.

The ultimate result of that was that I got to the pharmacy 17 minutes too late. I ran in, hoping, but no such luck.

Therefore, tonight is night without Depakote # 2. Tomorrow I'm likely to not feel so great....the rest of the week is going to be very hectic, so I'm hoping my mood doesn't notice.

But I'm so mad at myself. I know better. I know how vital my meds are and that I don't get to make mistakes. I know this. Yet it is so ridiculously hard to keep track of 6 meds, doses, etc.


Monday, July 02, 2007

Big Day

Today is a day of major achievements around here. First, we have surpassed 2000 visits. That's pretty exciting because it took a year to get 1000 and only 6 months to get the next 1000. Thanks to all who read; I'm so glad you're in my world.

I also had the very scary psychologist appointment. I did very well and said what needed to be said, including an apology. I feel so much better (especially because the anticipation was not pleasant) now. I think we're ready to move forward and maybe even make some progress again.

It's the first Monday in months I've not been angry at him. What will I do for fun now?

Anxiety II

Well, the anxiety isn't all gone. I knew this, especially because I still don't have the right balance going on so that I can take the appropriate amount of anxiety medication at night and still wake up in the morning. But tonight, wow.

Tomorrow is the day I'll talk to the psychologist about my new ideas about work. We also need desperately to talk about my lack of progress in therapy and my decision to not talk about work issues unless it is something truly new for a while. I need to just talk until I've said it all once I get there, but waiting until that time is not easy.

Oh how I wish for the perfect anxiety med, one that would read how much power it needs to put forth and react accordingingly.....(without side effects of course)